Roseana de Almeida Freitas

Correlation of Clinical, Histological, and Cytokeratin Profiles of Squamous Cell Carcinoma of the Oral Tongue With Prognosis

The aim of the present study was to clinically, morphologically, and immunohistochemically correlate the expression of cytokeratins (CKs) 7, 10, 13, 14, 16, and 19 in 30 cases of tongue squamous cell carcinoma (SCC) with disease outcome, metastases, clinical stage (tumor, node, metastasis [TNM]), and histological grade of malignancy proposed by Bryne. Statistical analysis (chi2 test) showed that only histological grading was not significantly correlated with the clinical variables. CK expression varied in the samples analyzed. CK 10 expression was significantly correlated with the presence of metastases, and the expression of CK 16 was related to disease outcome and also to TNM stages III and IV. These results indicate that metastases and TNM are effective prognostic indicators. The histological grading proposed by Bryne did not reflect the biological behavior of the tongue SCC cases studied. Analysis of some intermediate CK filaments can reflect the biological behavior and aggressiveness of some tongue SCCs.many aspects of this tumor, especially those related to prognosis, remain unknown. The aggressiveness of these tumors is related to different factors, including the histological degree, tumor size, level of involvement of neighboring tissues, presence of metastases at the time of diagnosis, and anatomical location of the tumor. With respect to anatomical location, cancer of the tongue shows a high potential of invasion and a high probability of developing metastases to the regional lymph nodes. Many studies have attempted to establish a correlation between the clinical and histological characteristics of oral cancer and its prognosis, but the results have been unsatisfactory. The objective of the present study was to correlate the outcome of the disease, clinical stage, and histological grade of malignancy proposed by Bryne with the expression of cytokeratins (CKs) in epidermoid carcinoma of the Introduction

Proliferating Cell Nuclear Antigen (PCNA) and p53 Protein Expression in Ameloblastoma and Adenomatoid Odontogenic Tumor

In this study, proliferating cell nuclear antigen (PCNA) and p53 protein expressions were analyzed in 16 cases of ameloblastoma and 8 cases of adenomatoid odontogenic tumor (AOT). The cases of ameloblastoma consisted of solid type tumors and histologic arrangements of different subtypes were observed. In some specimens, more than one histologic subtype was identified in the same lesion, and each tumor was categorized according to the predominant cell pattern. The odontogenic tumors were grouped as follows: follicular ameloblastoma (n=7), plexiform ameloblastoma (n=4), acanthomatous + follicular ameloblastoma (n=3), basal cell ameloblastoma (n=2), adenomatoid odontogenic tumor (n=8). PCNA immunohistochemical expression revealed stronger quantitative labeling index for the follicular ameloblastoma, while for p53 protein the strongest quantitative labeling index was detected in the plexiform type. Nevertheless, statistical analysis using ANOVA and Tukeys test did not detect significant differences (p>0.05) among the histologic subtypes of ameloblastoma. The findings of this study suggest that the different histologic patterns of ameloblastoma did not show a direct correlation with their clinical behavior and consequently with the prognosis of the cases. The results also indicated that the ameloblastoma has greater proliferative potential than the AOT, which can contribute to explain its more aggressive and invasive characteristics.

Immunoexpression of MMPs‐1, ‐2, and ‐9 in ameloblastoma and odontogenic adenomatoid tumor

OBJECTIVE The aim of this study was to evaluate and compare the expression of metalloproteinases-1, -2, and -9 in solid ameloblastoma and adenomatoid odontogenic tumor. METHODS A total of 20 cases of solid ameloblastoma and 10 cases of adenomatoid odontogenic tumors were selected and immunohistochemically assessed. Metalloproteinases-1, -2, and -9 immunoexpression and their distribution pattern were noted and semiquantitatively scored. The scores obtained were statistically analyzed. RESULTS Matrix metalloproteinase (MMP)-1 showed a predominant expression in both tumors and was found in stroma and parenchyma. For MMP-2, there was a varied expression, with 80% and 60% of immunoreactive tumor cells in ameloblastoma and adenomatoid odontogenic tumor respectively. Regarding stromal cells, 65% of ameloblastomas and 80% of adenomatoid odontogenic tumors showed positivity. There was immunoexpression of the MMP-9 in parenchymal and stromal cells in all cases of both tumors analyzed. A statistically significant difference in the expression of MMP-1 in relation to the expression of MMP-2 and -9 in ameloblastomas (P < 0.001) was observed. CONCLUSION The results suggest that these metalloproteinases are related to growth and progression of tumors analyzed, and particularly in ameloblastoma, its highest aggressiveness may be, in part, a result of the active participation of the stromal cells and their products, such as the MMPs studied.

Comparative analysis of the immunohistochemical expression of collagen IV, MMP-9, and TIMP-2 in odontogenic cysts and tumors.

OBJECTIVE The aim of this study was to evaluate the immunohistochemical expression of collagen IV, matrix metalloproteinase (MMP) 9 and tissue inhibitor of MMP (TIMP) 2 in dentigerous cysts (DCs), radicular cysts (RCs), keratocystic odontogenic tumors (KOTs), and ameloblastomas. STUDY DESIGN Twenty cases of DCs, 20 RCs, 20 KOTs, and 20 ameloblastomas were selected and analyzed by immunohistochemistry. RESULTS Most DCs and RCs showed continuous and >50% staining for collagen IV in the basement membrane of the epithelium, whereas predominantly discontinuous thin and ≤ 50% staining was observed in KOTs and ameloblastomas, with a significant difference in staining percentage (P < .001). MMP-9 was diffusely distributed and localized in both epithelial and mesenchymal cells of all of the lesions analyzed. The staining percentage was higher in the epithelium (P = .058) and mesenchyme (P = .005) of KOTs and ameloblastomas. Moreover, the distribution pattern, location, and percentage of expression of TIMP-2 were similar in the lesions studied, except for ameloblastoma, with a significant difference in staining percentage (P < .001). CONCLUSION These results demonstrate that the interaction between collagen IV, MMP-9, and TIMP-2 is an important factor for the establishment of differences in the biologic behavior of the odontogenic cysts and tumors studied.

Immunoexpression of vascular endothelial growth factor in periapical granulomas, radicular cysts, and residual radicular cysts

OBJECTIVE Our aim was to assess and compare the immunoexpression of vascular endothelial growth factor (VEGF) in periapical granulomas (PGs), radicular cysts (RCs), and residual radicular cysts (RRCs), relating it to the angiogenic index and the intensity of the inflammatory infiltrate. STUDY DESIGN Twenty PGs, 20 RCs, and 10 RRCs were evaluated by immunohistochemistry using anti-VEGF antibody. Angiogenic index was determined by microvessel count (MVC) using anti-von Willebrand factor antibody. RESULTS The PGs and RCs showed higher expression of VEGF than the RRCs. Lesions presenting few inflammatory infiltrate revealed the lowest immunoexpression of VEGF (P < .05). Irrespective of the intensity of the inflammatory infiltrate, most of the RCs and RRCs showed moderate to strong epithelial expression of VEGF. Lesions showing dense inflammatory infiltrate presented higher MVC indices (P < .05). VEGF expression and MVC did not reveal a significant correlation (P > .05). CONCLUSIONS VEGF is present in periapical inflammatory lesions but at a lower level in RRCs. The expression of this proangiogenic factor is closely related to the intensity of the inflammatory infiltrate in these lesions.

Epidemiologic profile of salivary gland neoplasms: analysis of 245 cases

AIM The aim of the present study is to establish the relative frequency and distribution of benign and malignant epithelial neoplasms of salivary glands in the Pathology and Cytology Laboratory, STUDY DESIGN Historic cohort. MATERIAL AND METHOD in the state of Sergipe, during the period 1980-1999. The neoplasms were individualized by gender, age, race of the patients, anatomic localization of the lesions and histopathological diagnosis. RESULTS Out of 162,312 registered cases, 245 were salivary gland epithelial neoplasms and 187 (76.33%) were benign and 58 (23.67%) were malignant. Pleomorphic adenoma was the most frequent benign neoplasm (89.94%) and adenoid cystic carcinoma represented the most prevalent malignant neoplasm (22.41%). The benign neoplasms occurred mainly between the second and third decades of life and showed preference for female, while malignant neoplasms were diagnosed between the sixth and seventh decades of life and in women. CONCLUSION The data demonstrate that epidemiology profile of studied neoplasms corroborated the majority researched literature.

Epidemiology and correlation of the clinicopathological features in oral epithelial dysplasia: analysis of 173 cases

Oral epithelial dysplasias (OEDs) are potentially malignant disorders characterized by diverse degrees of cellular atypia. The early and careful diagnosis has extreme importance, allowing prevention of the progression to the oral squamous cell carcinoma. This study aimed to determine the epidemiology and then correlate it with the clinicopathological features of OED. One hundred seventy-three cases of oral lesions retrieved from the files of a Service of Pathological Anatomy, covering a 38-year period, were submitted to descriptive statistical analysis through the Pearson χ(2) test. The majority of cases were from affected females (57.9%), with a peak of occurrence in the age group of 41 and 55 years (37.3%), white patients (64.8%), and those with lesions located on the gingiva/alveolar ridge (25.1%). The lesions predominantly presented with white color (56.8%) and were described as nodules (27.4%), with a rough surface (76.7%), an exophytic growth (79.1%), and a sessile base (95.6%). The majority of the lesions with degree of mild (34.6%) and moderate (34.9%) OED had clinical diagnosis of leukoplakia, whereas 33.3% of the lesions with degree of severe had clinical diagnosis of squamous cell carcinoma (P < .05). Tobacco use was the risk habit more related with OED (42.6%) (P > .05). The knowledge of OED epidemiology and clinical features provide a better understanding of the factors that possibly are associated with the malignant transformation of OED. Furthermore, these results contribute to supporting a prompt and accurate recognition of these lesions in clinical practice.

Immunoexpression of cyclooxygenase-2 and p53 in oral squamous cell carcinoma

PURPOSE Cyclooxygenase-2 (COX-2) is an induced proinflammatory enzyme involved in various steps of carcinogenesis such as cell proliferation, reduction in apoptosis rates, and promotion of tumor angiogenesis. Mutation or inactivation of the tumor suppressor gene p53 is frequently observed in malignant neoplasms and is known to be involved in the early stages of carcinogenesis. Recent studies reveal a possible correlation between COX-2 and p53 expression in several malignant neoplasms. The present study analyzed the correlation between the expression of COX-2 and p53 in oral squamous cell carcinoma (OSCC) and evaluated the differences in the expression of these 2 proteins according to the histologic grade of malignancy of the tumor. MATERIALS AND METHODS Thirty-four cases of OSCC were graded according to the histologic grading system proposed by Bryne [Oral Dis 4(2) (1998) 70-77]. Immunoexpression of COX-2 and p53 was analyzed by counting 1000 neoplastic cells in 5 different fields at the deep invasive front of the tumor under a light microscope. On the basis of the number of immunopositive cells, the labeling index expressed as the percentage of positively stained cells was established for each marker. RESULTS Increased COX-2 expression in most specimens was observed, although no significant correlation was observed between COX-2 and p53 labeling indices (P > .05). Moreover, there were no significant differences in the expression of these proteins between high- and low-grade tumors (P > .05). CONCLUSION The increased expression of COX-2 in OSCC suggests a role for this protein in the pathogenesis and progression of oral cancer.

Immunohistochemical expression of E-cadherin and β-catenin in ameloblastomas and tooth germs

OBJECTIVE The aim was to analyze the expression of E-cadherin and beta-catenin in ameloblastomas and tooth germs to determine their roles in cell differentiation processes and invasiveness compared with odontogenesis. STUDY DESIGN Twenty-one ameloblastoma cases (16 solid and 5 unicystic tumors) and 5 tooth germs were submitted to the immunohistochemical detection of E-cadherin and beta-catenin. Immunoreactivity was evaluated using descriptive and semiquantitative analysis, investigating the location and intensity of staining. The Fisher exact test was performed, and P values of <.05 were considered to indicate statistical significance. RESULTS There was no statistically significant difference in the expression of E-cadherin and beta-catenin between solid and unicystic ameloblastomas (P = .59; P = .63; respectively). The same was found when comparing solid and unicystic ameloblastomas with the tooth germs for both E-cadherin (P = .53; P = .44; respectively) and beta-catenin (P = .12; P = .16; respectively). Nuclear staining of beta-catenin was observed in only 4 cases (3 solid and 1 unicystic tumor). CONCLUSION The results showed no differences in the expression of E-cadherin or beta-catenin between tooth germs and solid and unicystic ameloblastomas. The expression of these molecules seems mainly to be related to the process of cell differentiation.

Analysis of local immunity in squamous cell carcinoma of the tongue and lower lip.

Antitumor immunity plays an important role in the development of and protection against malignancy. In general, patients with cancer are known to be immunologically compromised. The objective of this study was to evaluate local immunity in squamous cell carcinomas (SCCs) of the tongue and lower lip by immunohistochemistry, using anti-CD3, -CD4, -CD8, -CD25 and -zeta antibodies. Immunoexpression at the invasive front was compared considering anatomical tumor location and metastasis. The CD4/CD8 ratio was calculated for each case and associated with the variables. CD3+, CD4+, CD8+ and CD25+ cell counts were higher in SCCs of the lower lip and anti-zeta immunostaining was more evident in non-metastatic cases. CD8+ and CD25+ cell counts were also significantly correlated with tumor location (p=0.004 and p=0.004, respectively), with the observation of a larger number of these cells in SCCs of the lower lip. The CD4/CD8 ratio showed no significant association with metastasis or anatomical location. In conclusion, the clinical behavior of the oral SCC cases studied might be partially related to the immunohistochemical profile of the inflammatory infiltrate present at the invasive front.